New Member Registration

Section A - Delegate's details(Please do not use block capitals)

Name(as it will appear on your ID)

 

Address

Institution

Contact DetailsPlease enter phone numbers using international format, e.g. +64 9 123 4567

Special Requirements, if any

DIET

Section B - You and your privacy

Section C - Conference Registration Fee

NZSA / ASA Members
Early Bird
Standard
Consultant / Fellow
NZ$ 0.00 Early Bird
NZ$ 0.00 Standard
Registrar
NZ$ 0.00 Early Bird
NZ$ 0.00 Standard
Non-Member
Early Bird
Standard
Consultant / Fellow
NZ$ 0.00 Early Bird
NZ$ 0.00 Standard
Registrar
NZ$ 0.00 Early Bird
NZ$ 0.00 Standard
Technician / Nurse / allied health
NZ$ 0.00 Early Bird
NZ$ 0.00 Standard

 

Section D — Conference Activities

TOTAL FOR SOCIAL PROGRAMME
$0.00

Section E — Payment Options

 

Section F — Cancellation Policy